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The Challenge of Healthy Aging with Diabetes

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 9410

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Special Issue Editor

Prof. Dr. Tali Cukierman-Yaffe

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Guest Editor

1. Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
2. Department of Epidemiology, School of Public Health and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Interests: diabetes and cognitive dysfunction; diabetes and disability; frailty and sarcopenia; the challenges of healthy aging with diabetes

Special Issue Information

Dear Colleagues,

The risk of diabetes is increased by age. In the US, it has been reported that ~26% of those over the age of 65 have a diagnosis of diabetes, with disproportionally high attributed healthcare costs. Indeed, it has been estimated that 50% of the direct costs of diabetes in the US are attributed to people over the age of 65. In addition, data from the last decade suggest that diabetes may be viewed as a disease of accelerated aging. Older people with diabetes have a greater risk of functional limitation and physical disability than people without diabetes as well as a greater risk of cognitive dysfunction and an accelerated rate of cognitive decline and dementia. Despite this, there is a paucity of data with respect to this age group, especially with respect to the above-75 age group. There is a need for consensus on the definition of healthy aging in this group, and refinement of the economic burdens and risk (hyperglycemia, hypoglycemia) and protective factors. In addition, there is a need for evaluation of the effect of the different treatment modalities used in people with diabetes in this age group, specifically the effect of glucose control, which glucose indices to target, glucose monitoring, and other glucose technologies. Finally, there is a need for more data regarding interventions and technologies that may benefit this age group and its caretakers. Therefore, researchers in the field of diabetes in older age are encouraged to submit an original article or review to this Special Issue (case reports and short reviews will not be accepted).

Prof. Dr. Tali Cukierman-Yaffe
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

diabetes
aging
cognitive dysfunction
disability
sarcopenia
frailty
healthy aging
dementia
older people with diabetes
MCI

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Published Papers (4 papers)

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Research

Jump to: Review, Other

13 pages, 1822 KiB

Open AccessArticle

Characterizing Movement Patterns of Older Individuals with T2D in Free-Living Environments Using Wearable Accelerometers

by Tal Yahalom-Peri, Veronika Bogina, Yamit Basson-Shleymovich, Michal Azmon, Tsvi Kuflik, Einat Kodesh, Stefano Volpato and Tali Cukierman-Yaffe

J. Clin. Med. 2023, 12(23), 7404; https://doi.org/10.3390/jcm12237404 - 29 Nov 2023

Viewed by 1451

Abstract

(1) Background: Type 2 Diabetes (T2D) is associated with reduced muscle mass, strength, and function, leading to frailty. This study aims to analyze the movement patterns (MPs) of older individuals with T2D across varying levels of physical capacity (PC). (2) Methods: A cross-sectional study was conducted among individuals aged 60 or older with T2D. Participants (n = 103) were equipped with a blinded continuous glucose monitoring (CGM) system and an activity monitoring device for one week. PC tests were performed at the beginning and end of the week, and participants were categorized into three groups: low PC (LPC), medium PC (MPC), and normal PC (NPC). Group differences in MPs and physical activity were analyzed using non-parametric Kruskal–Wallis tests for both categorical and continuous variables. Dunn post-hoc statistical tests were subsequently carried out for pairwise comparisons. For data analysis, we utilized pandas, a Python-based data analysis tool, and conducted the statistical analyses using the scipy.stats package in Python. The significance level was set at p < 0.05. (3) Results: Participants in the LPC group showed lower medio-lateral acceleration and higher vertical and antero-posterior acceleration compared to the NPC group. LPC participants also had higher root mean square values (1.017 m/s²). Moreover, the LPC group spent less time performing in moderate to vigorous physical activity (MVPA) and had fewer daily steps than the MPC and NPC groups. (4) Conclusions: The LPC group exhibited distinct movement patterns and lower activity levels compared to the NPC group. This study is the first to characterize the MPs of older individuals with T2D in their free-living environment. Several accelerometer-derived features were identified that could differentiate between PC groups. This novel approach offers a manpower-free alternative to identify physical deterioration and detect low PC in individuals with T2D based on real free-living physical behavior. Full article

(This article belongs to the Special Issue The Challenge of Healthy Aging with Diabetes)

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12 pages, 590 KiB

Open AccessArticle

Differences in Associated Factors of Sedentary Behavior by Diabetes Mellitus Status: A Nationwide Cross-Sectional Study

by Dong Kee Jang, Hyung Seok Nam, Mina Park and Yeo Hyung Kim

J. Clin. Med. 2023, 12(17), 5453; https://doi.org/10.3390/jcm12175453 - 22 Aug 2023

Cited by 3 | Viewed by 1754

Abstract

This study aimed to identify the lifestyle and comorbidity factors associated with sedentary behavior by diabetes mellitus (DM) status. A total of 17,832 participants aged ≥50 years from the Korea National Health and Nutrition Examination Survey were included. Factors associated with long sedentary time (LST, ≥420 min/day) in individuals with and without DM (non-DM) were assessed. Among individuals with DM, LST was independently associated with excessive alcohol drinking (OR, 1.34; 95% CI, 1.02–1.74) and cardiovascular disease (OR, 1.47; 95% CI, 1.16–1.85). In individuals without DM, cancer (OR, 1.24; 95% CI, 1.06–1.44) and past smoking (OR, 1.16; 95% CI, 1.01–1.35) were independently associated with LST. Obesity (DM: OR, 1.28; 95% CI, 1.05–1.54; non-DM: OR, 1.24; 95% CI, 1.11–1.37), insufficient aerobic exercise (DM: OR, 1.55; 95% CI, 1.30–1.84; non-DM: OR, 1.50; 95% CI, 1.37–1.63), current smoking (DM: OR, 1.51; 95% CI, 1.11–2.05; non-DM: OR, 1.23; 95% CI, 1.05–1.45), and arthritis (DM: OR, 1.28; 95% CI, 1.04–1.56; non-DM: OR, 1.15; 95% CI, 1.04–1.27) were consistently associated with LST regardless of DM status. To reduce sedentary behavior time, it is important to consider an individual’s diabetes status and adopt a personalized approach. Full article

(This article belongs to the Special Issue The Challenge of Healthy Aging with Diabetes)

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Review

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18 pages, 367 KiB

Open AccessReview

Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers

by Justyna Rentflejsz and Zyta Beata Wojszel

J. Clin. Med. 2024, 13(4), 1107; https://doi.org/10.3390/jcm13041107 - 15 Feb 2024

Cited by 3 | Viewed by 3338

Abstract

Sarcopenia is a chronic, progressive skeletal muscle disease characterised by low muscle strength and quantity or quality, leading to low physical performance. Patients with type 2 diabetes mellitus (T2DM) are more at risk of sarcopenia than euglycemic individuals. Because of several shared pathways between the two diseases, sarcopenia is also a risk factor for developing T2DM in older patients. Various biomarkers are under investigation as potentially valuable for sarcopenia diagnosis and treatment monitoring. Biomarkers related to sarcopenia can be divided into markers evaluating musculoskeletal status (biomarkers specific to muscle mass, markers of the neuromuscular junction, or myokines) and markers assuming causal factors (adipokines, hormones, and inflammatory markers). This paper reviews the current knowledge about how diabetes and T2DM complications affect potential sarcopenia biomarker concentrations. This review includes markers recently proposed by the expert group of the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) as those that may currently be useful in phase II and III clinical trials of sarcopenia: myostatin (MSTN); follistatin (FST); irisin; brain-derived neurotrophic factor (BDNF); procollagen type III N-terminal peptide (PIIINP; P3NP); sarcopenia index (serum creatinine to serum cystatin C ratio); adiponectin; leptin; insulin-like growth factor-1 (IGF-1); dehydroepiandrosterone sulphate (DHEAS); C-reactive protein (CRP); interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). A better understanding of factors influencing these biomarkers’ levels, including diabetes and diabetic complications, may lead to designing future studies and implementing results in clinical practice. Full article

(This article belongs to the Special Issue The Challenge of Healthy Aging with Diabetes)

Other

Jump to: Research, Review

18 pages, 560 KiB

Open AccessSystematic Review

by Azizah Vonna, Mohammed S. Salahudeen and Gregory M. Peterson

J. Clin. Med. 2024, 13(2), 530; https://doi.org/10.3390/jcm13020530 - 17 Jan 2024

Viewed by 2230

Abstract

Limited data are available regarding adverse drug reactions (ADRs) and medication-related hospitalisations or emergency department (ED) visits in older adults with diabetes, especially since the emergence of newer antidiabetic agents. This systematic review aimed to explore the nature of hospital admissions and ED visits that are medication-related in older adults with diabetes. The review was conducted according to the PRISMA guidelines. Studies in English that reported on older adults (mean age ≥ 60 years) with diabetes admitted to the hospital or presenting to ED due to medication-related problems and published between January 2000 and October 2023 were identified using Medline, Embase, and International Pharmaceutical Abstracts databases. Thirty-five studies were included. Medication-related hospital admissions and ED visits were all reported as episodes of hypoglycaemia and were most frequently associated with insulins and sulfonylureas. The studies indicated a decline in hypoglycaemia-related hospitalisations or ED presentations in older adults with diabetes since 2015. However, the associated medications remain the same. This finding suggests that older patients on insulin or secretagogue agents should be closely monitored to prevent potential adverse events, and newer agents should be used whenever clinically appropriate. Full article

(This article belongs to the Special Issue The Challenge of Healthy Aging with Diabetes)

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